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Intracoronary endothelin receptor blockade improves endothelial function in patients with coronary artery disease

Felix Böhm1, Jens Jensen, Bertil Svane

  • 1Department of Cardiology, Karolinska Institutet and Karolinska University Hospital, Solna, S-171 76 Stockholm, Sweden. felix.bohm@ki.se

Canadian Journal of Physiology and Pharmacology
|November 18, 2008
PubMed

Insights

Endothelin receptor blockade improved coronary endothelial function and increased blood flow in patients with coronary artery disease. Selective ETA receptor blockade showed a greater increase in blood flow compared to dual ETA/ETB blockade.

Area of Science:

  • Cardiovascular Research
  • Pharmacology
  • Medical Science

Background:

  • Endothelin (ET)-1 receptor blockade is known to improve endothelial function in peripheral arteries.
  • Coronary artery disease (CAD) is characterized by impaired endothelial function and reduced coronary blood flow.

Purpose of the Study:

  • To investigate the effect of intracoronary endothelin receptor blockade on coronary endothelial function and blood flow in patients with CAD.
  • To compare the efficacy of selective ETA receptor blockade versus dual ETA/ETB receptor blockade.

Main Methods:

  • Ten patients with CAD received intracoronary infusions of either a selective ETA receptor antagonist (BQ123) or a combination of ETA and ETB receptor antagonists (BQ123 + BQ788).
  • Coronary endothelial function was assessed using substance P, an endothelium-dependent vasodilator, measuring coronary flow reserve with thermodilution (CFRThermo) and quantitative coronary angiography (QCA).
  • Changes in coronary blood flow were measured before and after receptor blockade.

Main Results:

  • Endothelin receptor blockade significantly improved the response to substance P, indicating enhanced endothelial function.
  • Intracoronary ET receptor blockade increased overall coronary blood flow by 16% (p < 0.05).
  • Selective ETA receptor blockade (BQ123) resulted in a greater increase in blood flow (22%) compared to dual ETA/ETB blockade (p < 0.05).

Conclusions:

  • Intracoronary endothelin receptor blockade is a potential therapeutic strategy for improving coronary vascular function in patients with coronary artery disease.
  • Selective ETA receptor blockade appears more effective in increasing coronary blood flow than dual ETA/ETB blockade in this patient group.

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